As I noted in my last post, mom’s confusion and hallucinations led to an emergency room visit. She had a follow-up visit with her doctor the following Monday. This general physician who had been treating her for decades could now see more troubling changes in her. The dementia that he thought could be treated by adjusting her medications was much worse. Her blood pressure remained too high.
The physician wrote a prescription for a home health nurse to follow-up in the next few days and evaluate the home situation. He also requested a social worker to do a home visit to evaluate the living-situation for both mom and dad.
This home health nurse was the same one, BJ, who had been visiting my parents monthly to give dad his shots. They both knew and trusted her. However, this time when she came to the door, mom didn’t recognize her at all. The house was hot (90 degrees inside) since it was July. The air conditioner was not turned on as mom and dad did not like air conditioning. Both mom and dad had higher than usual blood pressure when she got there.
BJ asked mom the usual questions about her health, but mom gave confused responses. She didn’t remember anything. BJ was concerned. The same day the social worker came out and found mom confused as well. Together the social worker and nurse conferred and prepared their recommendations for the doctor.
BJ telephoned me and said it was not safe for mom and dad to remain alone in their mobile home. Dad had Alzheimer’s and was dependent on mom for his medication management and meals. Now mom that was confused, she couldn’t even manage her own medications. She had been shopping and cooking for them both too, but now it was even less safe for her to cross busy street to get groceries. With her confusion, even cooking might not be a safe activity for her.
BJ said the social worker would have to recommend a forced placement in an Assisted Living Facility (ALF) for them as they were unsafe in the community. She said they needed to choose an ALF and move there immediately or else the Sheriff could come and force them into one (not of their own choosing) under the auspices of the adult protective services.
Mom was extremely upset. She was confused and unable to care for herself and dad, and yet didn’t like the “pressure to make a decision”. I tried to convince her to come north to the community where I live so I could help her and dad with the move and afterwards. She insisted on staying in that southern town where her doctor was. She didn’t want to change doctors and start with new ones. Finally I said I didn’t care if she moved to an ALF in the south or the north, just do it NOW.
Fortunately, I had already toured an assisted living facility in that community that I thought would be satisfactory. In fact, Essie had even taken mom and dad to tour that same ALF the previous November. Mom had liked the place, but insisted they couldn’t afford the cost. I told her it was now time to spend the money they had saved “for their old age”, but I couldn’t convince her at that time. Now, however, there was no choice. I told mom to let Essie take her to tour the ALF again and then make a deposit. I would fly south to help them move when they are ready to move in.
Mom and dad liked the apartment they were shown and packed their suitcases to move the following Monday. I spoke with the management and arranged for them to prepare a double room (two singles side by side with a door in between.) In the meantime mom and dad were staying in 2 separate fully furnished “respite rooms” down the hall from each other and didn’t like that very well.
As soon as they had moved into the ALF, even in the respite rooms, mom’s health started to improve. Now she and dad were getting their medications dispensed from the nursing station at the proper times and dosages. The indoor temperatures were controlled so they were not too hot as they had been in the mobile home. And they were getting healthy meals three times a day.
Once a date had been set for the actual move of their furniture and belongings, I bought my tickets to fly down south to help them. My son also arranged to stay 4 days and help me help them.
So, after years of trying to arrange home health services for mom and dad, they would not need them anymore. I called to cancel dad’s case management services, as well as to take them off the list for home care for the following fall. Mom had already cancelled all the other services for the summer. At least for now, mom and dad would not be returning north for the summer. They would stay in the south through the winter. I planned to spend part of the coming winter in the same community when the snow covered my northern city. After that, I still hoped to bring them north, but did not say that at this time. I just wanted them to be safe for the time being.